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To the Editor: The systematic review by Drs McGettigan and Henry¹ provides a timely summary of the observational studies investigating the cardiovascular risk associated with nonsteroidal anti-inflammatory drugs. Nonetheless, as pointed out in the accompanying editorial by Dr Graham,² data on the cardiovascular risk of celecoxib remain in conflict. Our case-control study,³ which was published too recently to be included in the meta-analysis, found a significantly increased risk of acute myocardial infarction associated with rofecoxib and celecoxib, as well as the newer etoricoxib. These findings are at odds with the conclusion of McGettigan and Henry that celecoxib in commonly used doses may not increase cardiovascular risk.

There is important heterogeneity in the observational studies that may have contributed to the variations in findings with respect to the risk with celecoxib. While differences in patterns of drug utilization and duration, population comorbidity, and reference groups could have played a role, we . . . [Full Text of this Article]

Frank Andersohn, MD
frank.andersohn@charite.de
Department of Clinical Pharmacology
Charité–Universitaetsmedizin Berlin
Berlin, Germany

Samy Suissa, PhD
Division of Clinical Epidemiology
Royal Victoria Hospital
Montreal, Canada

Edeltraut Garbe, MD, PhD
Department of Clinical Pharmacology
Charité–Universitaetsmedizin Berlin

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Cyclooxygenase Inhibitors and Cardiovascular Risk—Reply
David Henry and Patricia McGettigan
JAMA. 2007;297(6):587-588.
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